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Coping Strategies Used by Food Insecure Households

9. května 2016 aktualizováno: RTI International

Understanding the Interdependencies Among Three Types of Coping Strategies Used by Very Low Food Security Households With Children

Children without consistent access to sufficient and nutritious food show sustained disadvantages. To improve food security, households utilize three types of coping strategies- participating in governmental feeding and financial assistance programs; obtaining food from nongovernment providers; and using individually developed strategies. To understand the interdependencies among strategies and decision-making processes used to select them, the investigators conducted a two-phased, mixed-methods study using a socio-ecological theoretical framework. First, employing a cross sectional, observational design the investigators administered in-person surveys to 320 adults in very low food secure (VLFS) households with children. Over 1 year later, the investigators repeated select questions and conducted in depth interviews with a cohort (n=28) of participants. Descriptive statistics defined magnitude of associations among strategies. Following bivariate analysis, the investigators assessed interdependencies and factors affecting relationships with log-linear models. The investigators analyzed interviews using an hierarchically ordered, analytical coding structure. With Qualitative Comparative Analysis (QCA), the investigators developed typologies of VLFS and created models treating food security as an outcome. The association of soup kitchen use and nutritionally risky behavior was altered by Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Food safety-related risky behavior level related to intensity of food pantry use by participation in school food programs. Supplemental Nutrition Assistance Program (SNAP) did not affect the association between soup kitchen use and risky food safety behaviors. Key interview constructs included becoming and being short of food; coping strategies; decisions used to inform choice of strategies; and managing a devalued social status. Improved income stability was a necessary condition for improving food security.

Přehled studie

Postavení

Dokončeno

Podmínky

Intervence / Léčba

Detailní popis

Food insecurity is a serious issue facing households in the United States. In 2012, the time this study was begun, the U.S. Department of Agriculture reported that almost 15% of U.S. households and one in five households with children were considered to be food insecure. Over one third of these experienced very low food security (VLFS), with multiple indicators of disrupted eating patterns due to inadequate resources. These statistics are of particular concern because children without consistent access to sufficient and nutritious food show sustained disadvantages, including effects on cognition, academic performance, long-term nutritional status, and psychosocial development. To improve their food security, households utilize three types of coping strategies- (1) participating in federal feeding and financial assistance programs ("safety net"), (2) obtaining food from nongovernment Emergency Food Providers (EFPs), and (3) using individually developed coping strategies. The objectives of this study related to developing a better understanding of the coping strategies that VLFS households with children use to ensure that their households have sufficient food. Specifically, the study addressed two main research questions: What are the interdependencies among three types of coping strategies: participating in federal feeding and financial assistance programs ("safety net"), obtaining food from EFPs, and using individually developed coping strategies. What decision-making processes do people in VLFS households with children use when selecting coping strategies to ensure that their households have sufficient food? The investigators conducted a two-phased mixed-methods study of coping strategies used by VLFS households with children <18 years in North Carolina (NC), using a socio-ecological theoretical framework to guide their hypotheses, methods, and analyses. For phase I, the investigators employed a cross sectional, observational design. The investigators used a two-stage sample to recruit 320 clients of service providers who offer assistance to people with limited resources within eight NC counties with the highest food insecurity rates. Trained interviewers administered in-person a survey interview asking clients socio-demographic questions and about their use of three categories of coping strategies. Using a longitudinal design, more than a year after Phase I, in Phase II, the investigators completed in depth interviews with a cohort (n=28) of Phase I participants, selected using maximum variation sampling. During the largely unscripted interviews, participants were asked a select number of close ended questions from Phase I, including the 18 item food security module, to assess changes over the past year and permit comparisons between times one and two. To address the first question, two by two and multi-dimensional contingency tables were constructed to analyze the interdependencies among the three types of coping strategy outcomes. Descriptive statistics (odds ratios, counts and percentages) were performed to define the magnitude of the association among coping strategies. Fisher's exact tests and Chi-square statistics were then employed to assess the statistical significance of the interdependency among the outcomes. To further determine the interdependencies among the three coping strategies, and to assess how individual and household-level factors affect those interdependencies, the investigators employed log-linear models. To address the second research question, the investigators formulated a hierarchically ordered, analytical coding structure that reflected key decision-making constructs (e.g., knowledge of coping strategies, perception of risk of accessibility and availability of coping strategies, barriers to participation in "safety net" programs) and examined the results in terms of the key constructs. Lastly, responses to both sets of questions were jointly reviewed using Qualitative Comparative Analysis (QCA), a mixed-methods analysis technique. The investigators implemented a conventional, crisp set for (1) developing typologies of households and individuals experiencing very low food insecurity, and (2) exploring pathways to improving food security status among participants in the follow-up interviews. All procedures involving human participants was reviewed and approved by RTI International's Institutional Review Board (IRB).

Typ studie

Pozorovací

Zápis (Aktuální)

320

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

  • Spojené státy
    • North Carolina
      • Asheboro, North Carolina, Spojené státy, 27203
        • Christians United Outreach Center
      • Asheboro, North Carolina, Spojené státy, 27203
        • Salvation Army
      • Clarkton, North Carolina, Spojené státy, 28433
        • Bladen Family Support
      • Elizabethtown, North Carolina, Spojené státy, 28337
        • Bladen Crisis Assistance Center
      • Ellenboro, North Carolina, Spojené státy, 28040
        • Liberty Baptist
      • Forest City, North Carolina, Spojené státy, 28043
        • Chase Corner UMC Ministries
      • Forest City, North Carolina, Spojené státy, 28043
        • Grace Country Kitchen at Grace of God Rescue Mission
      • Gibson, North Carolina, Spojené státy, 28343
        • St. John's UMC
      • Laurel Hill, North Carolina, Spojené státy, 28351
        • Higher Dimensions
      • Laurinburg, North Carolina, Spojené státy, 28352
        • Church Community Service of Scotland County
      • Laurinburg, North Carolina, Spojené státy, 28352
        • Laurinburg Hope In Christ Ministries
      • Lumberton, North Carolina, Spojené státy, 28358
        • Robeson County Church and Community Center
      • New Bern, North Carolina, Spojené státy, 28560
        • Living Bread Holiness Church
      • New Bern, North Carolina, Spojené státy, 28560
        • Religious Community Services
      • Pembroke, North Carolina, Spojené státy, 28372
        • Sacred Pathways
      • Rutherfordton, North Carolina, Spojené státy, 28139
        • Little White Country Church
      • St. Pauls, North Carolina, Spojené státy, 28384
        • New Bethel Church
      • Williamston, North Carolina, Spojené státy, 27892
        • Black Swamp Church of Christ
      • Williamston, North Carolina, Spojené státy, 27892
        • Holy Trinity Church
      • Williamston, North Carolina, Spojené státy, 27892
        • Liberty Christian Center Food Pantry
      • Williamston, North Carolina, Spojené státy, 27892
        • Unlimited Care
      • Wilson, North Carolina, Spojené státy, 27893
        • Christ Deliverance Tabernacle Ministries
      • Wilson, North Carolina, Spojené státy, 27893
        • New Christian Food Pantry
      • Wilson, North Carolina, Spojené státy, 27893
        • Salvation Army
      • Wilson, North Carolina, Spojené státy, 27893
        • Wilson County Interfaith Services: Hope Station
      • Wilson, North Carolina, Spojené státy, 27894
        • Willson Praise & Worship Church

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

320 clients of service providers who offer assistance to people with limited resources within eight North Carolina counties with the highest food insecurity rates. Using a longitudinal design, more than a year after Phase I, in Phase II, the investigators completed in depth interviews with a cohort (n=28) of Phase I participants

Popis

Inclusion Criteria::

  • 18 years of age or older
  • responsible for getting food for household
  • household assessed to have very low food security
  • children <18 in household
  • consent to participate

Exclusion Criteria:

  • less than 18 years of age
  • never responsible for getting food for household
  • no children <18 in household
  • do not consent to participate

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Identify participants who have used at least one target coping strategy
Časové okno: Initial contact
Participants were administered a survey to document their use of at least one target coping strategy within the last twelve months
Initial contact

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

RTI International

Vyšetřovatelé

  • Vrchní vyšetřovatel: Andrea Anater, Ph.D., RTI International

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia

1. května 2012

Primární dokončení (Aktuální)

1. prosince 2014

Dokončení studie (Aktuální)

1. prosince 2014

Termíny zápisu do studia

První předloženo

11. dubna 2016

První předloženo, které splnilo kritéria kontroly kvality

9. května 2016

První zveřejněno (Odhad)

10. května 2016

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Odhad)

10. května 2016

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

9. května 2016

Naposledy ověřeno

1. května 2016

Více informací

Termíny související s touto studií

Klíčová slova

Další identifikační čísla studie

  • 13224

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